| Part oneMagnetic resonance imaging patterns of multiple gliomasPurpose:The purpose of this study was to analyze and summarize multiple gliomas'imaging features and the key points of diagnosis by observing and summarizing the MR1 patterns of multiple gliomas in the brain.Materials and Methods:Retrospectively reviewed 303 cases of diffuse glioma with preoperative MRI examination and postoperative pathology in our hospital from 2013 to 2018.The pathological types in this study include:glioblastoma(WHO ?),anaplastic astrocytoma(WHO ?),,diffuse astrocytoma(WHO ?).Localize glioma,such as pilocytic astrocytoma(WHO ?)and pilomyxoid astrocytomas(WHO ?),were not included in this study.According to magnetic resonance imaging,a total of 63 cases of multiple glioma were selected.The images were analyzed by a radiologist with 14 years of experience in radiology and a radiologist with 10 years of experience in radiology.The key points of image analysis were judged from the following aspects:(1)the multi-center and multi-focus glioma were judged based on the imaging,and the possible spread modes of multi-focus glioma among the lesions was observed.(2)imaging features of all lesions.(3)the key points of differential diagnosis of imaging.Results:There were 43 cases(68.3%)of glioblastoma(WHO ?),12 cases(19.0%)of anaplastic astrocytoma(WHO ?)and 8 cases(12.7%)of diffuse astrocytoma(WHO?).According to the classification of growth patterns,there were 59 cases of multifocal glioma and 4 cases of multicentric glioma.Cortical involvement and high interfocal heterogeneity were the imaging features.Accroding to the mode of spread,the multifocal glioma were divided into 4 groups:along white matter fiber bundle(55.6%),along subependymal and small vessel space(38.1%),along meningia-subarachnoid space(9.5%),and direct invasion(65.1%).According to the imaging features and key points of differential diagnosis,they can be divided into metastatic type(69.8%),granulomatous type(4.8%),abscess type(12.7%),encephalitis type(6.3%)and metabolic encephalopathy type(6.3%).Conclusions:The manifestations of multiple gliomas on MRI are diverse,and it is necessary to differentiate them from at least five types of intracerebral multiple lesions.Understanding the imaging features of multiple gliomas and combining them with clinical practice can improve the diagnostic accuracy of multiple gliomas.Part twoMultimodal MRI study on the high imaging heterogeneity of multiple gliomasPurpose:Multimodal MRI and histogram analysis were used to observe the heterogeneity of multiple gliomas compared with single gliomas.Materials and Methods:Retrospectively included 48 patients with multiple gliomas who underwent preoperative MRI in our hospital from January 2013 to April 2018,and confirmed by surgery or biopsy.48 cases of single glioma matched with age,gender and collection time were randomly selected from hospital's database.Histogram analysis was used to analyze multimodal MRI data including precontrast and contrast-enhanced T1-weighted images(T1WI),T2-weighted images(T2WI)and Difxusion weighted images(DWI),and to calculate the parameters of histogram analysis in tumors.Two t-test samples were used to compare the two groups,and histogram parameters with statistical differences in multiple gliomas were selected for correlation analysis with pathological index Ki-67.Results:Compared with single glioma patients,Kurtosis value(kv),Skewness value(sv)of T2WI and mean?the 25%quantile(Q1)?median and Kurtosis value(kv)of ADC showed significant differences in multiple gliomas.There was a negative correlation between ADC histogram parameter Q1 and Ki67 in multiple gliomas.Conclusions:Multiple gliomas have higher heterogeneity than single gliomas,and heterogeneity is associated with biological behavior of tumors. |
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